|Home | About | Journals | Submit | Contact Us | Français|
A 45-year-old man had a severe traumatic brain injury (TBI) with multicompartmental hemorrhages (figure 1). He was initially noted to be awake and following commands with his right side. Two weeks later, his examination deteriorated to coma with flaccid quadriplegia. Initial workup, including EEG, was unrevealing. MRI brain showed new multiterritorial infarcts (figure 1); a catheter-based angiogram confirmed severe vasospasm in several large vessels (figure 2).
Vasospasm following TBI has been previously described as underrecognized because it is often clinically silent, and typically occurring in the first several days when symptomatic.1,2 Late and extreme cases, as above, are rarely described.
Download teaching slides: Neurology.org
Dr. Reznik: study design, analysis/interpretation of the data, drafting/revising the manuscript. Dr. Saeed: analysis/interpretation of the data, revising the manuscript. Dr. Shutter: study design, analysis/interpretation of the data.
No targeted funding reported.
The authors report no disclosures relevant to the manuscript. Go to Neurology.org for full disclosures.